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General NPI Number Information
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NPI Number | 1316763337
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Entity Type | Individual
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Provider Name | ANTHONY J ROGERS
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Gender | Male
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Dates
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Enumeration Date | 11/25/2024
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 812 OAK ST
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City | CONWAY
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State | AR
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Zip | 72032-4408
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Country | US
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Telephone | 501-327-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 400 S MAIN ST STE 100
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City | SEARCY
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State | AR
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Zip | 72143-7801
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Country | US
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Telephone | 501-279-9000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | AR
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